Functional decline
Increasing dependence with ambulation, transfers, dressing, bathing, feeding, or continence.
Hospice eligibility guidelines
A practical reference for recognizing when a patient may be appropriate for hospice evaluation. These guidelines support, but do not replace, physician judgment, Medicare rules, or a full clinical review.
Prognosis standard
6 months
Hospice eligibility begins with a physician's prognosis of six months or less if the illness runs its normal course.
Team review
IDT
The hospice medical director and interdisciplinary team review the full clinical picture, not one isolated finding.
Local access
24/7
Treasure Coast Hospice admissions can talk through appropriateness any hour at 772-403-4500.
Start here
General decline often tells the story first
A patient does not need every sign below. Look for a pattern: declining function, escalating needs, and goals shifting toward comfort.
Nutritional decline
Unintentional weight loss, reduced intake, dysphagia, dehydration, or low albumin when clinically relevant.
More acute episodes
Repeated infections, falls, emergency visits, hospitalizations, or harder-to-control symptoms.
Treatment limits
Disease-directed options are no longer helping, no longer desired, or no longer tolerated.
Caregiver strain
Family or facility staff are struggling to manage symptoms, medications, safety, or care needs between visits.
Goals changing
The patient or surrogate is prioritizing comfort, time at home, dignity, and fewer crisis-driven decisions.
Disease indicators
Common hospice eligibility prompts by diagnosis
Use these as conversation starters and documentation prompts. The admissions team can help interpret the full record.
Non-disease-specific baseline
Baseline decline strengthens the clinical picture across diagnoses.
What functional findings matter most?
Document dependence in activities of daily living, reduced mobility, falls, pressure injuries, dysphagia, recurrent infections, and any clear change from the patient's prior baseline.
What nutritional markers are helpful?
Note weight trends, decreasing oral intake, dehydration, dysphagia, aspiration risk, and albumin when available. These do not qualify a patient alone, but they help tell the prognosis story.
Diagnosis-specific prompts
These examples mirror common Medicare-aligned patterns, not automatic rules.
Dementia and neurologic disease
Consider FAST stage 7 or beyond for dementia, loss of ambulation, dependence with dressing and bathing, incontinence, limited meaningful speech, dysphagia, aspiration, pressure injuries, infections, or recurrent falls.
Heart and lung disease
Look for dyspnea at rest or with minimal exertion, oxygen dependence, repeated exacerbations, treatment-resistant symptoms, recurrent admissions, NYHA Class IV symptoms, or poor response despite optimal therapy.
Cancer and multisystem decline
Consider progressive or metastatic disease, declining performance status, decision to stop disease-directed therapy, uncontrolled symptoms, cachexia, or increasing dependence.
This page is general education for clinicians. Final eligibility depends on physician certification, the patient's goals, and the complete clinical record.
Referral details
What helps admissions respond quickly
A complete referral lets the team review appropriateness, reach the right decision-maker, and coordinate the first visit without avoidable back-and-forth.
Patient basics
Name, date of birth, current location, county, primary contact, and best phone number.
Clinical picture
Primary diagnosis, recent decline, hospitalizations, functional status, symptom burden, medications, and available labs or notes.
Care goals
What the patient and family understand, what they are hoping for, and whether comfort-focused care has been discussed.
When uncertain
A hospice evaluation can clarify the next right step
Asking about eligibility does not obligate a patient to enroll. It gives the patient, family, and care team a clearer picture of options while there is still time to plan.
Documentation
A stronger note answers three questions
Eligibility documentation is most useful when it shows the whole arc of illness, not only the terminal diagnosis.
What changed?
Describe decline over weeks or months: function, intake, cognition, symptoms, complications, or care setting.
What has been tried?
Include therapies, hospitalizations, procedures, medication changes, and why further disease-directed care is not helping or desired.
What matters now?
Document goals of care, code status when known, and the patient's or surrogate's comfort-focused priorities.
Need a clinical read on eligibility?
Call admissions or send a referral. Treasure Coast Hospice serves Martin, St. Lucie, and Okeechobee counties with local support available around the clock.